Ventilator-Associated Pneumonia

Gianluigi Li Bassi; Miquel Ferrer; Joan Daniel Marti; Talitha Comaru; Antoni Torres

doi:10.1055/s-0034-1384752

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2014; 35(04): 469-481
DOI: 10.1055/s-0034-1384752

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ventilator-Associated Pneumonia

Authors

Gianluigi Li Bassi

¹Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain

²Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

³Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Spain
Miquel Ferrer

¹Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain

²Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

³Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Spain
Joan Daniel Marti

¹Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain
Talitha Comaru

¹Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain
Antoni Torres

¹Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain

²Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

³Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Spain

Abstract

Ventilator-associated pneumonia (VAP) is an iatrogenic pulmonary infection that develops in tracheally intubated patients on mechanical ventilation for at least 48 hours. VAP is the nosocomial infection with the greatest impact on patient outcomes and health care costs. Endogenous colonization by aerobic gram-negative pathogens, that is, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus play a pivotal role in the pathogenesis of VAP. Several preventive strategies have shown efficacy in decreasing VAP incidence and are often implemented altogether as a prevention bundle. In patients with clinical suspicion of VAP, respiratory samples should be promptly collected. The empiric treatment should be based on the local prevalence of pathogens, duration of hospital stay, and prior antimicrobial therapy. The antibiotics can be stopped or adjusted to more narrow-spectrum once cultures and susceptibilities are available.

Keywords

ventilator-associated pneumonia - nosocomial pneumonia - pseudomonas aeruginosa - endotracheal tube - mechanical ventilation

Full Text

References

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